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Crisis: Theory and Intervention

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1 Crisis: Theory and Intervention
Chapter 21: Crisis: Theory and Intervention Copyright © 2012, 2007 Mosby, Inc., an affiliate of Elsevier Inc. All rights reserved.

2 Historic and Theoretic Perspectives
Equilibrium Homeostasis Crisis intervention

3 Crisis Psychological disequilibrium
Stressful event with the potential to overwhelm and strain coping A turning point for growth and change May encouragement movement from complacency

4 Four Defining Components
Specific, unexpected and non-routine events Create uncertainty Perceptions of threat Transformational

5 Risk Factors for Crisis
Concurrent or multiple bio-psychosocial stressors Multiple losses Limitations Chronic pain/disability Poor or inadequate support networks Limited access to health care

6 Types of Crisis External Internal Maturational Adventitious

7 Caplan’s Phases Individual is exposed to a stressor
Prior coping strategies fail to relieve Mobilization of resources to resolve and alleviate discomfort Absence of crisis resolution leads to major disorganization

8 Human Response to Crisis
A person’s response is often an ordinary response to an extraordinary event An attempt to restore balance Crisis disrupts bio-psychosociospiritual homeostasis

9 Potential Responses to Crisis
Shock Numbness Denial Dissociative behavior Confusion Disorganization Difficulty making decisions Suggestibility Physiologic symptoms

10 Psychological Stages After a Disaster
Heroic Phase Honeymoon phase Disillusionment phase Reconstruction

11 Situational Crises Result from external stressors:
Threat to safety or well-being Job loss Divorce Death of loved one Serious medical condition Natural disasters Man-made disasters

12 Psychiatric Disorders Associated With Crisis
Depression Anxiety disorders Adjustment disorders Posttraumatic stress disorder (PTSD)

13 Additional PTSD Symptoms in Children
Regressed behavior Increased fears Poor concentration Decreased academic performance Increased oppositional behavior Irritability and aggression Emotional lability Depression

14 Method of Crisis Intervention
Assessment Planning therapeutic intervention Intervention Resolution of crisis Anticipatory planning

15 Crisis Intervention Offer short-term strategic therapy.
Provide timely intervention. Stabilize victims with order and routine. Facilitate understanding of event (gather facts, listen, teach). Use available resources to promote independent functioning. Encourage self-reliance. Assist with practical coping strategies.

16 Global Intervention Art and science of dealing with natural and
man-made disasters Reduce loss of life and property Protect communities from hazards

17 Crises Caused by Psychiatric Emergencies
Urgency Impending doom Intolerable anxiety Sense of being overwhelmed Inability to cope May not recognize the need for help

18 Psychiatric Emergencies
Life-threatening behavior Life disrupting Life impairing

19 Robert’s Model A: Assessment and appraisal of immediate medical needs, threats, property damage, and trauma C: Connection to support and disaster relief T: Trauma treatment plans

20 Prevention Strategies
Primary Secondary Tertiary

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